42 Risk of Potentially Preventable Hospitalizations After COVID-19 Infection Among US Veterans

Oregon Convention Center 

Potentially preventable hospitalizations (PPH) are used to measure health system performance. During the COVID-19 pandemic, disruptions to healthcare may have hindered disease treatment and increased the risk of PPH. Messaging to stay home when sick, as well as post-infection sequelae may have compounded risks among those with COVID-19. Using an emulated target trial design with monthly sequential trials, we compared risk of a PPH among 189,136 Veterans with COVID-19 between March 1, 2020, and April 30, 2021 and 943,084 matched uninfected comparators. The primary outcome was a first PPH in Veterans Health Administration (VHA) hospitals, or in community hospitals either paid by VHA or Medicare fee-for-service. Extended Cox models were used to examine adjusted hazard ratios (aHRs) of PPH among Veterans with COVID-19 and comparators during varying follow-up periods: 0-30, 0-90, 0-180, and 0-365 days. In total, 3.1% (3.8% of infected and 3.0% of comparators) of Veterans had a PPH during one-year follow-up. The risk of a PPH was greater among Veterans with COVID-19 than comparators in four follow-up periods: 0-30-day aHR=3.26; 0-90-day aHR=2.12; 0-180-day aHR=1.69; 0-395-day aHR=1.44.

emulated target trial

preventable hospitalization

extended Cox modelling

SARS-CoV-2

COVID-19

Veterans 

Section on Statistics in Epidemiology